Split Hospitalizations: a Model for Mood Disorders

Abstract

Depression is a major burden for society. While most mood disorders are treated on an outpatient basis, specific indications warrant hospitalization. Besides progresses in pharmacology, psychotherapy, or interventional procedures, we suggest that the hospital setting could also be used as a tool to address specific aspects of the mood disorder problem. Hospitalizations may present some iatrogenic effects and participate to the chronicization of some inpatients. In this paper, we propose a split hospitalization model for the treatment of mood disorders, where the stay in the hospital is split by a period of return to home, to test their ability to find own solutions to their mood difficulties. This split model could offset some of the negative effects inherent in long-term or repeated hospitalization, and chronicization. This model, where patients are treated as actors of their recovery supports the self-efficacy dimension by deconstructing a self-fulfilling prophecy based on the idea that the main function of the hospital is to serve as an asylum where the patient seeks protection against own self-destructive tendencies. This article outlines how the system was set up, described the expected therapeutic prospects, and presents a critical discussion of the main issues at stake.

Keywords: resistant depression - personality disorder - split hospitalizations - mood disorders - self-efficacy.